Dr. Manoj Sharma, a Professor of Social and Behavioral Health and Internal Medicine answers queries on schizophrenia
By Dr. Manoj Sharma
Arushi’s story
Arushi* is a 22-year-old American-born only daughter of a first-generation couple, Rahul* and Vidya* who reside in the San Francisco Bay area. Both have established a successful business in nutraceuticals. Recently Arushi started hearing voices that tell her to act impulsively. She also told her parents that she sees people when her parents cannot see them. She further confided in them that she was being controlled by someone from outer space. Her parents recently consulted a psychiatrist who diagnosed her with schizophrenia and prescribed medication. Both Rahul and Vidya are extremely worried about her and under stress. They approached us with some questions.
Q: What is schizophrenia and how common is it?
Dr. Sharma: Schizophrenia is a serious mental illness that is associated with disability and affects all areas of life including personal, family, educational, social, and occupational spheres. It affects thinking, feelings, and behaviors, and distorts them. Some common symptoms of schizophrenia include what you are describing: hearing or seeing things that are unreal (hallucinations), false beliefs (delusions), fixation in a particular position (catatonia), and social withdrawal. Diagnosis should only be made by trained mental health professionals like psychiatrists. Worldwide about 24 million people or 1 in 300 are affected by it (0.32%).
Q: What is the treatment for schizophrenia?
Dr. Sharma: Although, at present, there is no “cure” for schizophrenia, it can be managed. Recently there has been a lot of advancement in the management of schizophrenia. The treatment is lifelong. An individualized approach with a tailored home treatment plan implemented with the help of a crisis resolution mental health team is often helpful. Management typically includes medication like antipsychotics and psychotherapy i.e. cognitive behavioral therapy, psychoeducation, etc. within familiar family surroundings and the option of having a professional mental health team comprising social workers, community mental health nurses, pharmacists, counselors, psychotherapists, psychologists, and psychiatrists available in moments of crisis. There is a lot of stigma and discrimination associated with this disorder and therefore there is a need to protect the rights of people like Arushi.
Q: What can we do to protect Arushi’s rights?
Dr. Sharma: That is a very good question. First, ensuring that Arushi has access to appropriate treatment and adheres to it diligently is very important. You are already doing that. You and Arushi should be aware of all the side effects of the treatment and Arushi should provide informed consent. She should also have access to trusted support systems besides the two of you.
Next, you should plan for her future needs like education, employment, earnings, and housing. You should investigate advance directives to document treatment preferences in case of future incapacity. She is likely to face stigma and discrimination, and you can protect her from that by being supportive and asking for reasonable accommodation at education and work.
At the societal level, you could be an advocate for people suffering from mental illnesses and build a support network for her. You can connect her to organizations like the National Alliance on Mental Illness (NAMI), Schizophrenia & Psychosis Action Alliance, Students for Psychosis, and others. At the same time, you should not forget to take care of yourselves as the caregivers.
Q: What should we as parents and caregivers?
Dr. Sharma: First, you should prioritize your own care because if you do not do that you cannot take care of Arushi. This entails having balanced meals at proper times, exercising regularly, sleeping 7-8 hours daily, managing your stress levels, doing your daily duties, and maintaining an optimistic, patient, and cheerful attitude. Next, you should educate yourself about her illness and treatment, monitor Arushi’s medication management, encourage compliance with treatment, provide her with unconditional emotional support, help her maintain daily routines, assist her in social activities as needed, be vigilant for signs of relapse, and regularly communicate with her psychiatrist and mental health team.
Q: Can Indian philosophy help us in any way?
Dr. Sharma: Indian philosophy can help in coping with stress associated with schizophrenia. Techniques like yoga and meditation that emphasize introspection and mindfulness can be effective coping mechanisms.
Q: Can you refer me to some additional resources in this area?
Dr. Sharma: Here are some additional resources from where you can find more information:
The National Institute of Mental Health (NIMH)’s website on schizophrenia: https://www.nimh.nih.gov/health/topics/schizophrenia
National Health Service, UK: Treatment of schizophrenia: https://www.nhs.uk/mental-health/conditions/schizophrenia/treatment/
American Psychiatric Association’s website on schizophrenia: https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia
WebMD’s website with a slide show on the disease: https://www.webmd.com/schizophrenia/ss/slideshow-schizophrenia-overview
Stress management book with individual chapters on various aspects of managing stress: https://www.sciencedirect.com/book/9780128112953/practical-stress-management
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Manoj Sharma, MBBS, Ph.D., MCHES® is an Indian-American global public health expert, author, and educator who has written several books and publications on mental health and wellness. He answers queries from a medical, behavioral, social, and philosophical perspective. He is a Social and Behavioral Health Professor at the School of Public Health and an Adjunct Professor of Internal Medicine at the University of Nevada, Las Vegas. He is also President of Health for All, Inc.
Courtesy: India Currents (Posted on Feb 12, 2025)
